25例患者血浆置换过程中并发症的预防与护理

The prevention and nursing for the complications of 25 patients with plasma exchange

目的探讨血浆置换在临床应用中常见并发症的相关原因、预防及护理对策,保证临床血浆置换治疗的顺利完成。方法对本组25例患者进行血浆置换共53次,采用Prismaflex系统CRRT机,TPE-2000血浆分离器,将患者含有毒素或致病物质的血浆分离出来,同时代之以1000-3000m L新鲜冰冻血浆,通过对治疗过程中并发症的的观察,总结出并发症的发生原因,并及时制定相应的预防及护理措施。结果 25例患者中有1例患者出现过敏反应;1例出现低血压;1例发生低血钙;未见穿刺针脱出滑出、出血倾向及感染等严重并发症的发生。结论掌握熟练的操作技术和术中的密切观察护理可以预防血浆置换并发症的发生,是保证血浆置换顺利完成的关键。

Objective To investigate the related causes, prevention and nursing countermeasure of common complications in the clinical application of plasma exchange and then guarantee the completion of clinical plasma exchange treatment. Methods This group contains 25 cases of patients who have been operated with plasma exchange at 53 times totally. The Prismaflex system CRRT machine and TPE-2000 plasma separator were used to separate patients serum containing toxins or pathogenic substance, replacing with 1000 to 3000 m L fresh frozen plasma. It is expected to summarize the causes resulting in the complications from the observation in the process of treatment, and make corresponding measurements to prevent and nurse. Results Among 25 cases of patients, it appeared allergic reaction for 1 case; developed hypotension for 1 case and 1 case of low blood calcium; No serious complications were observed such as puncture needle dropping out, bleeding tendency, and infection. Conclusion It could be achieved to prevent the occurrence of complications in plasma exchange via the skilled operation techniques and the close observation and nursing in operation, which are also very crucial to accomplish plasma exchange successfully.